Healthcare Provider Details

I. General information

NPI: 1417644360
Provider Name (Legal Business Name): AGRA MEDICAL GROUP APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 LAUREL CANYON BLVD
NORTH HOLLYWOOD CA
91605-3149
US

IV. Provider business mailing address

7535 LAUREL CANYON BLVD
NORTH HOLLYWOOD CA
91605-3149
US

V. Phone/Fax

Practice location:
  • Phone: 818-570-5002
  • Fax:
Mailing address:
  • Phone: 818-570-5002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RASHITA AGGARWAL
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 818-570-5002